Podcasts about lowering healthcare costs

"Nomi actually stands for 'no middleman'. Take out that invented complexity... Price comes way down, becomes more simple to administer, and there's plenty of dollars to go around for providers now making more money." - Josh WalkerMy guest this week, Josh Walker, Founder & COO of Nomi Health, is on a mission to rebuild healthcare by tackling its "invented complexity." He joined me on the show to explain why creating a direct relationship between the buyers and providers of care is the key to a better, more affordable system for everyone.How does Nomi do it? We break down their playbook, which focuses on three core strategies: standardizing data formats to improve efficiency, embracing price discovery to find the true cost of care, and simplifying payment dynamics to cut out the middlemen.This isn't just theory. Joshua shares the powerful, real-world results of their model, including how one client's benefits leader received a standing ovation from employees after switching to a plan that eliminated all financial barriers to care.Tune in this week to learn why it's so important to find the true cost of care, and why I'm so proud to have Nomi as a sponsor for the show!Chapters:(00:00:44) What Does NOMI Stand For? (00:11:36) Finding the "True Cost of Care" (00:23:27) Do We Even Need Networks Anymore? (00:35:14) What Churros Can Teach Us About Data Analytics (00:52:19) From Solution Taker to Solution Maker (00:55:59) The "Standing Ovation" Health PlanKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"Nomi actually stands for 'no middleman'. Take out that invented complexity... Price comes way down, becomes more simple to administer, and there's plenty of dollars to go around for providers now making more money." - Josh WalkerMy guest this week, Josh Walker, Founder & COO of Nomi Health, is on a mission to rebuild healthcare by tackling its "invented complexity." He joined me on the show to explain why creating a direct relationship between the buyers and providers of care is the key to a better, more affordable system for everyone.How does Nomi do it? We break down their playbook, which focuses on three core strategies: standardizing data formats to improve efficiency, embracing price discovery to find the true cost of care, and simplifying payment dynamics to cut out the middlemen.This isn't just theory. Joshua shares the powerful, real-world results of their model, including how one client's benefits leader received a standing ovation from employees after switching to a plan that eliminated all financial barriers to care.Tune in this week to learn why it's so important to find the true cost of care, and why I'm so proud to have Nomi as a sponsor for the show!Chapters:(00:00:44) What Does NOMI Stand For? (00:11:36) Finding the "True Cost of Care" (00:23:27) Do We Even Need Networks Anymore? (00:35:14) What Churros Can Teach Us About Data Analytics (00:52:19) From Solution Taker to Solution Maker (00:55:59) The "Standing Ovation" Health PlanKey Links for Social:@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFundedListen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

In an industry full of pharmacy rockstars, few stand out like Scott Pace. An Arkansas-based pharmacist and lawyer, Scott Pace is all about advancing patient care at the governmental level — he was also a former guest on the Catalyst Pharmacy Podcast so it was high time to see what he's been up to. In this episode, join host Mark Bivins and Scott as they discuss everything from the DIR Hangover, the congressional roundtable on PBM reform, and a good helping of leadership-based Prescribables.   Roundtable on Lowering Healthcare Costs and Bringing Transparency to Prescription Drug Middlemen: https://www.youtube.com/live/DiA6hAslOFg?si=GLaPFXrcZlyZ-awj  Hosted By: Mark Bivins, SVP of Sales  Guest: Scott Pace | Owner, Kavanaugh Pharmacy Looking for more information about independent pharmacy? Visit www.pioneerrx.com

In this episode, Goodroot CEO Mike Waterbury shares his innovative approaches to medical and pharmacy cost transformation; living up to his title as the "10th Man in Healthcare"; He gives his insights into tackling medical debt as well as other hot topics!Michael Waterbury is founder and Chief Executive Officer of  Goodroot , a community of companies reinventing healthcare one system at a time.For over 25 years Mike has studied the healthcare system from the inside out. He advanced from a financial role to an executive leadership role at Oxford Health Plans, and then Magellan Health Services. While at Magellan, Mike pioneered the integration of ICORE Healthcare, a company focused on solving specialty pharmacy challenges, and the development of a new medical pharmacy program.Mike was inspired to become an entrepreneur and create a company that could change pharmacy rebates and formularies for the better. In 2015, he founded RemedyOne, which became the first Goodroot company. Now 6 companies strong, Goodroot is a community of companies committed to reinventing healthcare one system at a time. That team has created a passionate culture Mike is proud of, and has produced outcomes that have changed thousands of lives for the better by saving over $800M in healthcare costs. Mike continues to free and amplify talent to join the Goodroot cause working towards a goal of saving the healthcare system $30 billion in the next five years.  Recent articles by MikeLet's stop calling it medical 'debt' in Fierce HealthcareHigh-deductible health plans are causing medical debt. It's time to fix them. in BenefitsPRO4 Actions Business Leaders Can Take Today to Stop Medical Debt in Real Leaders5 changes that need to be made to improve the overall US healthcare system in Thrive Warren Buffett Tried to Kill the 'Tapeworm' of Healthcare Costs But Couldn't Do It. Maybe Entrepreneurs Can. in Entrepreneur

Listen to Part 1 here.Alica Sparling  00:00You have to have innovative positions and you have to bring in a new way of thinking that complements the decision making and focus on economic value.Gina DiPietro  00:14That's Alica Sparling on her innovative role as Novant Health vice president senior healthcare economist. And you're listening to Industry Insights: A healthcare podcast presented by Novant Health. I'm Gina DiPietro, your host, here with part two of our series on healthcare economics. It's often used by government agencies, tech companies like Google and Amazon, and in academia. There's now a growing demand for healthcare data scientists, as you heard in part one. A deeper dive in this episode on using incentives to modify people's behavior, and the role of health economics as organizations navigate a large-scale crisis like a pandemic. Here again is Alica who begins with more on her health disparities research.Alica Sparling  01:02I really like the focus on health equity, and the social impact that I see in the health industry right now. When we think about costs and when we think about effectiveness, you cannot think about the patient population as being one big homogenous group. We have patients with different constraints and different backgrounds, and it's a very diverse, heterogeneous group. And when we make improvements, we need to be paying attention to who is benefiting, and who is being left behind. So, look at how the new drug or how the new implant or how the new service is going to effect not only cost and effectiveness, but also equity. In other words, what is their effect separately on vulnerable populations? Whether we define them by race, ethnicity, or by socioeconomic status (or some kind of combination) versus the majority.Gina DiPietro  01:55When those gaps or disparities are found, you said that it's led by the clinicians as far as figuring out how to solve that. But are you part of the solution, as well? And if so, how do you play a part in helping to close that gap?Alica Sparling  02:10Yes, definitely. We are providers of healthcare. So, any solutions are going to involve providing health care. Closing equity gaps is led by clinicians, and their input is invaluable. But health services scientists and social science studies disparities and health equity issues, as well. So their contribution is very important, as is the contribution of data people. So you have to collaborate on these interventions.Gina DiPietro  02:35Gina here with a quick recap from part one. And there's still time to hit that pause button and listen to our first discussion. So, PhD economists are trained in econometrics - a combination of math, statistics and economic theory. It transforms data and theoretical concepts into useful tools for decision making. Think of Alica as an internal economic consultant. She's a link between the data and people who can influence change. Now, back to Alica who was explaining how data analysis can be used to improve health equity.Alica Sparling  03:08These interventions are usually either some kind of outreach to patients, helping break down barriers for patients to receive care, helping providers provide better care and maybe be more aware of disparities. So, you need to do a data analysis to really understand what are the barriers for vulnerable populations. Maybe it is the fact that they don't have transportation to get there. Maybe it's the fact your office closes too early, and they have to work and they are not able to go somewhere after 5pm. You need to know exactly what's driving the decision making. And if you want to change their decision making, then you have to create an intervention that is focused and enables the patient to change that behavior. Every time you do an intervention like that, immediately think about how you're going to measure the impact of that intervention. Do you have good metrics? How will you know if it's working or not? And so incorporate that, too. Before you spend too many resources on anything, you should know if it's working.Gina DiPietro  04:08People respond to incentives, and you mentioned a few that have worked. Does anything else come to mind?Alica Sparling  04:15Yes, it's interesting. So we talked about patients. So, let's talk about providers a little bit. So for providers, when you think about incentives, the first one that comes to mind, of course, is the economic incentive - payments to physicians or nurses for something that you want them to do or focus on. There are also non-monetary incentives, or behavioral nudges, that work. And that could be, for example, peer comparison. You can just tell people, 'This is what you're doing. This is what other people are doing.' And that works very well, evidence shows. Education always works. People sometimes don't know what's right. So, having evidence-based care and educating people about the proper way to disseminate information. And the last thing is what we call the clinical decision support. With the help of computers, you can also give incentives to providers to do certain things over others. Just simply by how (and what) you position on their screens. If you don't want them to do something, make it difficult to do. Let's say it takes three clicks to do one thing versus something that you want them to do. You can actually position that on top of a pulldown menu and then they're more likely to do that. So, these are the behavioral nudges that are helping with incentives and getting us to modify provider behavior.Gina DiPietro  05:30I'm also curious, what's the impact of a position like a healthcare economist for organizations as they navigate a large-scale crisis like the pandemic? What does that look like? And what's the value both directly and indirectly?Alica Sparling  05:48The effect of the pandemic on the healthcare system (or on a hospital system, a provider or a patient) is definitely a question that economists can address. And they can help think through all of the effects and help leaders. For example, with the pandemic, a question you can ask is what is happening to the population size? If the population size is contracting, then on the macro-level you can expect aggregate demand to fall. You can expect also the labor supply to fall. If people are getting sick, then you can expect an increase in demand for medical care. With COVID-19, we have seen an increase in demand for Emergency Departments and for ICUs. So, we can consider the labor force. Do we have enough people to care for patients? Is the labor force itself changing? And for example, one of the things we have seen is that there has been an increase of traveling nurses, which partially have been needed because we needed more labor force in the ICUs. But maybe partially what is happening is that nurses are changing from being in their traditional roles to the roles of traveling nurses, because maybe the financial incentives are there to make the switch. So, if there is a change in the labor force and how the services are provided, how does that change the product itself? That's going to effect both quality and costs, and patients' wellbeing.Gina DiPietro  07:18What other companies or industries or types of organizations are employing health economists, or alternatively, have not yet gone there, but probably should?Alica Sparling  07:29First of all, health economics has been around for a long time. But traditionally, health economists have been employed in academia, in government agencies like Medicare. The Congressional Budget Office has health economists who are very important. You also have health economists that have been hired at health insurance companies. They have not been that prevalent in health systems like Novant Health. But I can foresee that changing. And I see that there is a lot of work for health economists within health systems. Each health system can tailor the role of the health economist to what is important for them and where they have gaps. I could see that some health economists might be focused only on economic evaluation, especially if their background is in pharmacoeconomics, because it's almost like it's a specialization within health economics. Or maybe some large health systems would have specializations that are focused only on behavioral economics. So, creating these new programs and incentives and figuring out the proper ways to evaulate. You can employ theoretical knowledge from behavioral economics about behavioral nudges. Or you can have economists who are more generalists; that can be brought in to help with brainstorming and questions - doing this kind of internal consulting. And also oversee and help with more sophisticated data analysis. Like, how are these different variables and things related to each other? And that requires more sophisticated techniques. And that can be done through statistics. It can be done through artificial intelligence (AI) and machine learning (ML). And depending on the question, you choose which method is correct. And you see this done a lot outside of healthcare. There has been a lot of hiring of economists, for example, by Google or by Amazon, where they are conducting some really rigorous statistical analysis to better understand the population of their consumers.Gina DiPietro  09:29Novant Health CEO Carl Armato and Dr. Eric Eskioglu - they saw the value in hiring you as a vice president senior healthcare economist. But what would you say to a decision maker at a company who's been fighting to get a position like yours created but hasn't yet been successful?Alica Sparling  09:49Well, of course, go for it! I am very fortunate and I'm very grateful to have this position. And I think it is an important position to have in this world of constant change. You have to innovative and you have to bring in a new way of thinking that complements the decision making. And Novant Health is being innovative by hiring an economist and focusing on economic value.Gina DiPietro  10:12You're just getting started at Novant Health. What are you most excited about as you sort of dig into this work?Alica Sparling  10:20The flexibility of this position. How innovative it is. And how we are targeting things that I really think are the most important ones to target with health economics. We want to eliminate unwarranted clinical variation, improve health equity and social impact, and give incentives to provide value. And I am involved in all of this. And I get to work across the whole organization with leaders and clinicians. And it's work that is ultimately important for patients, and is going to improve the way we provide care. And we will provide it at a lower cost, which is ultimately also good for the patients' access to care.Gina DiPietro  11:05I know you've worked in academia. Is there anything that's surprised you so far about being in this healthcare space?Alica Sparling  11:14When you work with students, you see stars in their eyes. They're very happy and excited and curious and want to learn. Well, I see the same thing with people who are my age peers, who are leaders, who are doctors. They have natural intellectual curiosity, and want to make the world a better place. They want to learn and do new things, and that's everywhere - regardless of age and positions. And that is very encouraging. It's a wonderful thing to see.Gina DiPietro  11:47Thank you for listening to this episode of Industry Insights. Find others, like how AI is improving health outcomes, on the Industry Insights channel of the Novant Health podcast family. Listen on Apple, Google, Spotify, or anywhere you get your podcasts. I'm your host, Gina DiPietro, and hope to see you back here real soon.Listen to Part 1 of our series on healthcare economics here.

Josh and Kayla are joined by Jason Huffman, the executive director of Americans for Prosperity in West Virginia, to continue their discussion from episode one on certificate of need and its impact on healthcare costs for people of the mountain state.

On their debut episode, Josh and Kayla are joined by Jim Kaufman, the West Virginia Hospital Association's President & CEO, to discuss certificate of need, how it relates to the lowering of healthcare costs in the mountain state and more.

On this week's episode of the Healthcare Happy Hour we are taking a break from the crazy politics in Washington to focus on potential data-driven solutions to lower healthcare costs. Susan Dentzer, Senior Policy Fellow for the Robert J. Margolis Center for Health Policy at Duke University and host of Optum's new health policy podcast Until It's Fixed joins us to discuss what's working and what isn't working in our healthcare system and how we can lower costs through untangling administrative complexity.

On this week’s episode of the Healthcare Happy Hour we are taking a break from the crazy politics in Washington to focus on potential data-driven solutions to lower healthcare costs. Susan Dentzer, Senior Policy Fellow for the Robert J. Margolis Center for Health Policy at Duke University and host of Optum’s new health policy podcast Until It’s Fixed joins us to discuss what’s working and what isn’t working in our healthcare system and how we can lower costs through untangling administrative complexity.

Exploring Reference-Based Pricing as a Method for Lowering Healthcare Costs by Managed Care Cast

Maryland Representative Andy Harris, an anesthesiologist, joins the Freedom Caucus Podcast for a deep dive into price transparency within the healthcare system and highlights efforts to end surprise medical billing.

Michael Menerey: Being a Cost Effective Leader    Michael Menerey is a Senior Vice President and Benefits Consultant with Alliant Insurance Services and a partner in the Employee Benefits Practice. He is the author of The CEO’s Guide to Lowering Healthcare Costs by 33% and is also the host of the Reconstructing Healthcare Podcast. He is focused on educating employers on alternative methods to reduce costs and improve benefits for their employees.     Questions You'll Hear Today:   You've indicated that on average, the cost of healthcare/health insurance for employers has increased over 200% over the last 16 years. Why do healthcare costs continue to rise at this pace? What can employers do to mitigate these increases? As a business leader, how can I offer cost effective benefits and leverage it to attract and retain talented employees? If I'm a CEO or business leader that wants to learn more about some of the things you've mentioned, where can I get more information? How can millennials make an impact in their organization when it comes to benefits and healthcare costs? What advice do you have for millennials looking to take a leadership role in their organizations?   Connect with Michael Menerey:   Website:  www.reconstructinghealthcare.com Email:  mmenerey@alliant.com info@reconstructinghealthcare.com   Connect with Danielle Taylor:   Facebook:  https://www.facebook.com/M2CEOPodcast Website:  M2CEO Podcast Email: danielle@turnkeypodcast.com  Youtube: Youtube Channel LinkedIn: Danielle Taylor Profile Instagram: https://www.instagram.com/m2ceopodcast/   Show Notes by Show Producer: Jessie Taylor   Audio production by Turnkey Podcast Productions. You're the expert. Your podcast will prove it.   

Over the last 16 years, healthcare premiums have increased by 200%. Inevitable? Just how the system has to be? Not according to Michael Menerey, author and host of the Reconstructing Healthcare podcast. He joins us to share his take on the healthcare challenge, common myths he’s uncovered and ways employers and employees can take action. We’ll cover alternatives to the traditional approach and give you actionable ways to start changing the system for the better.   How to Support this Show: Subscribe on your favorite podcast app (iTunes, Stitcher, Google Play, etc.) Review us on iTunes Take our survey and we'll enter you in a drawing for a free book Follow Xenium HR (@XeniumHR) and Brandon Laws (@BrandonLaws) on Twitter, LinkedIn & Instagram Learn more about Xenium HR at xeniumhr.com   About Michael Menerey: Michael Menerey is a Senior Vice President and Benefits Consultant with one of the largest Employee Benefits Brokerage & Consulting firms in the country.  Michael enjoys collaborating with his clients to challenge the status quo approach to benefits and is constantly evaluating new products, vendors and strategies that can drive lower costs and create value for employers, employees, and their dependents. Listen to the Reconstructing Healthcare podcast Get the free ebook CEOs Guide to Lowering Healthcare Costs by 33%

  If you want better results in terms of health insurance, then you need a different approach. Michael Menerey is helping businesses find health care strategies that are effective and cost-friendly. He joined us to discuss his "Reconstructing Healthcare" movement and his book The CEO's Guide to Lowering Healthcare Costs by 30%.

Listen to Michael Menerey teach us how to lower healthcare costs by challenging the status quo!  If you are the founder of a business, an entrepreneur growing your business or a CEO trying to stay in business, you probably are watching your healthcare costs and employee benefits soaring out of sight. What to do? The first step is to listen what to Michael Menerey, Senior Vice President and Benefits Consultant with Alliant Employee Benefits, has to tell us in this podcast. You'll learn a lot about what can be done to manage employee benefit costs. Don't miss this one! You probably are thinking, "Yes, healthcare is really broken." What happened and what can we do about it? Just look at what has occurred as a result of the current consolidations. Where are all those cost savings that were promised? Over the last 16 years, health insurance premiums have increased by over 201% and employee contributions towards healthcare premiums are up 350%, and this trend is only expected to continue. If you run a business, listen to how Michael could help you, the same way he helps other employers restructure their health plans to yield lower costs and improved benefits for their employees. In this highly informative podcast, he shows you how to find alternatives to the usual health insurance strategies. You know you don't want higher costs, so what can you do to find better solutions?  Michael's answer is simple: If employers want better results, they have to scrap the traditional health insurance structure and leverage creative strategies in the marketplace to proactively lower their health insurance costs. He is an expert at this, and he shares his wisdom with us so we can do it too. If you want better results, you need a different approach.  "Traditional Health Insurance is a game you're guaranteed to lose," proclaims Michael's website. It goes on to say—and this is what Michael expands upon in our podcast—that we are at a unique point in time where "technology, capital and innovation all seem to be converging upon a healthcare industry that has been resistant to change and successful at keeping new entrants at bay." Michael's out to change that, challenging the status quo approach to benefits and constantly evaluating new healthcare products, vendors and strategies that can drive down costs and create value for employers, employees and their dependents.  Passionate about helping businesses, he offers video training and other educational resources and hosts the podcast series Reconstructing Healthcare that explores what is wrong with the current U.S healthcare system, examines what drives higher healthcare costs and exposes deficiencies in traditional insurance products. Michael recently published "The CEO's Guide to Lowering Healthcare Costs by 30%" to help business owners and executives begin to see the inefficiencies in traditional healthcare purchasing and also to provide a roadmap on how to get better results. Recently, he was recognized as one of Risk & Insurance Magazine's 2017 Power Broker® Rising Stars. For more on today's healthcare issues, you might find these blogs and podcasts of value:  Innovative Solutions Abound As Healthcare Shifts From the Hospital to the Home  The Unintended Consequences of Healthcare Consolidations  What To Do Now That Consumers Are Redesigning Their Own Healthcare Solutions? Linda MacCracken—The New World of Patient Care Ask Andi—Why Companies Have Got To Change Or They Will Not Thrive Resources mentioned in this episode: Michael's podcast: Reconstructing Healthcare My book: "On the Brink: A Fresh Lens to Take Your Business to New Heights" Simon Associates Management Consultants website Download the 1-page synopsis of my book, "On the Brink: A Fresh Lens to Take Your Business to New Heights" here

Are you maximizing your company benefits? Michael Menerey is a Senior Vice President and Benefits Consultant with Alliant Employee Benefits and author of The CEO’s Guide to Lowering Healthcare Costs by 30%. Alliant, one of the largest Employee Benefits Brokerage & Consulting firms in the country, helps businesses manage their employee benefit costs, stay in compliance and educate their employees on how to best use their benefit plan. Michael is also host of the Reconstructing Healthcare Podcast, discussing innovative solutions for employers to lower their healthcare costs.

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